Healthcare Provider Details

I. General information

NPI: 1598670176
Provider Name (Legal Business Name): DELORES MATTHIESSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7211 GLYNOAKS DR
LINCOLN NE
68516-4243
US

IV. Provider business mailing address

5250 S 50TH ST
LINCOLN NE
68516-2207
US

V. Phone/Fax

Practice location:
  • Phone: 402-440-3374
  • Fax:
Mailing address:
  • Phone: 402-580-1199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: